Home Health ICD-9/ICD-10 Alert

Reader Questions:

Remember Primary Diagnosis Code for These Diabetics

Question: I am coding a claim that includes the following: "secondary diabetes w/ renal manifestations." Do I have enough information to choose a diagnosis code with these notes?

-- Michigan Subscriber

Answer: You have enough there to choose 249.40 (Secondary diabetes mellitus with renal manifestations; not stated as uncontrolled or unspecified) for the patient's secondary diabetes.

To paint a complete diagnosis picture for this patient, however, you also need to code for the associated condition. So let's say that the patient's diabetes was causing Kimmelstiel-Wilson syndrome. You could then report the following:

  • 249.40 to represent the patient's secondary diabetes;
  • 581.81 -- Nephrotic syndrome; with other specified pathological lesion in kidney; nephrotic syndrome in diseases classified elsewhere, to represent the Kimmelstiel-Wilson syndrome.

If there is not additional information to explain the diabetic renal disease, code diabetic nephropathy NOS (583.81) as the manifestation.

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